COVID-19 severity and vaccine breakthrough infections in idiopathic inflammatory myopathies, other systemic autoimmune and inflammatory diseases, and healthy controls: a multicenter cross-sectional study from the COVID-19 Vaccination in Autoimmune Diseases (COVAD) survey

Hoff LS, Ravichandran N, Shinjo SK, Day J, Sen P, Junior JG, Lilleker JB, Joshi M, Agarwal V, Kardes S, Kim M, Milchert M, Makol A, Gheita T, Salim B, Velikova T, Gracia-Ramos AE, Parodis I, O'Callaghan AS, Nikiphorou E, Tan AL, Chatterjee T, Cavagna L, Saavedra MA, Ziade N, Knitza J, Kuwana M, Nune A, Distler O, Cansu DU, Traboco L, Wibowo SAK, Tehozol EAZ, Serrano JR, Garcia-De La Torre I, Wincup C, Pauling JD, Chinoy H, Agarwal V, Aggarwal R, Gupta L (2022)

Publication Type: Journal article

Publication year: 2022

Journal

DOI: 10.1007/s00296-022-05229-7

Abstract

Objectives: We aimed to compare the spectrum and severity of COVID-19 and vaccine breakthrough infections (BIs) among patients with IIMs, other systemic autoimmune and inflammatory diseases (SAIDs), and healthy controls (HCs). Methods: This is a cross-sectional study with data from the COVAD study, a self-reported online global survey that collected demographics, COVID-19 history, and vaccination details from April to September 2021. Adult patients with at least one COVID-19 vaccine dose were included. BIs were defined as infections occurring > 2 weeks after any dose of vaccine. Characteristics associated with BI were analyzed with a multivariate regression analysis. Results: Among 10,900 respondents [42 (30–55) years, 74%-females, 45%-Caucasians] HCs were (47%), SAIDs (42%) and IIMs (11%). Patients with IIMs reported fewer COVID-19 cases before vaccination (6.2%-IIM vs 10.5%-SAIDs vs 14.6%-HC; OR = 0.6, 95% CI 0.4–0.8, and OR = 0.3, 95% CI 0.2–0.5, respectively). BIs were uncommon (1.4%-IIM; 1.9%-SAIDs; 3.2%-HC) and occurred in 17 IIM patients, 13 of whom were on immunosuppressants, and 3(18%) required hospitalization. All-cause hospitalization was higher in patients with IIM compared to HCs [23 (30%) vs 59 (8%), OR = 2.5, 95% CI 1.2–5.1 before vaccination, and 3 (18%) vs 9 (5%), OR = 2.6, 95% CI 1.3–5.3 in BI]. In a multivariate regression analysis, age 30–60 years was associated with a lower odds of BI (OR = 0.7, 95% CI 0.5–1.0), while the use of immunosuppressants had a higher odds of BI (OR = 1.6, 95% CI 1.1–2.7). Conclusions: Patients with IIMs reported fewer COVID-19 cases than HCs and other SAIDs, but had higher odds of all-cause hospitalization from COVID-19 than HCs. BIs were associated with the use of immunosuppressants and were uncommon in IIMs.

Authors with CRIS profile

Involved external institutions

Universidade Potiguar (UnP) Brazil (BR) Sanjay Gandhi Post Graduate Institute of Medical Sciences (SGPGIMS) India (IN) University of São Paulo / Universidade de São Paulo (USP) Brazil (BR) Royal Melbourne Hospital (RMH) Australia (AU) Maulana Azad Medical College (MAMC) India (IN) University of Manchester United Kingdom (GB) Byramjee Jeejeebhoy Government Medical College & Sassoon General Hospital India (IN) Mahatma Gandhi Mission Institute of Health Sciences (MGMIHS) India (IN) Istanbul University / İstanbul Üniversitesi Turkey (TR) University of Illinois at Urbana-Champaign United States (USA) (US) Pomeranian Medical University / Pomorski Uniwersytet Medyczny w Szczecinie (PMU) Poland (PL) Mayo Clinic United States (USA) (US) Cairo University Egypt (EG) Fauji Foundation Hospital Pakistan (PK) Hl. Kliment Ochridski-Universität Sofia Bulgaria (BG) Instituto Mexicano del Seguro Social Mexico (MX) Karolinska Institute Sweden (SE) Autonomous University of Barcelona (UAB) / Universitat Autònoma de Barcelona Spain (ES) King’s College London United Kingdom (GB) Leeds Teaching Hospitals NHS Trust United Kingdom (GB) Policlinico San Matteo Pavia Fondazione IRCCS Italy (IT) Université Saint-Joseph (USJ) / جامعة القديس يوسف / Սուրբ Ժոզեֆի համալսարան Lebanon (LB) Nippon Medical School Japan (JP) Southport and Ormskirk Hospital NHS Trust United Kingdom (GB) University of Zurich / Universität Zürich (UZH) Switzerland (CH) Eskişehir Osmangazi Üniversitesi Turkey (TR) St. Luke's Medical Center – Global City Philippines (PH) University of Indonesia (UI) / Universitas Indonesia Indonesia (ID) Instituto Nacional de Enfermedades Respiratorias Mexico (MX) Hospital General de Occidente (HGO) Mexico (MX) University College London (UCL) United Kingdom (GB) University of Bristol United Kingdom (GB) University of Pittsburgh United States (USA) (US)

How to cite

APA:

Hoff, L.S., Ravichandran, N., Shinjo, S.K., Day, J., Sen, P., Junior, J.G.,... Gupta, L. (2022). COVID-19 severity and vaccine breakthrough infections in idiopathic inflammatory myopathies, other systemic autoimmune and inflammatory diseases, and healthy controls: a multicenter cross-sectional study from the COVID-19 Vaccination in Autoimmune Diseases (COVAD) survey. Rheumatology International. https://doi.org/10.1007/s00296-022-05229-7

MLA:

Hoff, Leonardo Santos, et al. "COVID-19 severity and vaccine breakthrough infections in idiopathic inflammatory myopathies, other systemic autoimmune and inflammatory diseases, and healthy controls: a multicenter cross-sectional study from the COVID-19 Vaccination in Autoimmune Diseases (COVAD) survey." Rheumatology International (2022).

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